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VAERS ID: 1000247

AGE: UNK| SEX: F|State: FR

Description

died; This is a spontaneous report from a contactable physician downloaded from the Medicines Agency (MA) WEB [AT-BASGAGES-2021-00572]. A 86-year-old female patient received BNT162B2 (COMIRNATY) on Jan2021 Intramuscular at single dose for COVID-19 immunisation. The patient's medical history included: Dementia (continuing), Ataxia (continuing), Transient ischaemic attack (TIA), Struma nodosa (continuing). Concomitant medication was not reported. The patient died a few days after receiving the Covid vaccination on 25Jan2021. It was unknown if autopsy was done. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: unknown cause of death

Symptoms

Death

Vaccines

VAX DATE: 01 January 2021 | ONSET DATE: 25 January 2021 | DAYS TO ONSET: 24
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))

        RECVDATE:
        04 February 2021
        CAGE_YR:
        CAGE_MO:
        RPT_DATE:
        DIED:
        Y
        DATEDIED:
        25 January 2021
        L_THREAT:
        ER_VISIT:
        HOSPITAL:
        HOSPDAYS:
        X_STAY:
        DISABLE:
        RECOVD:
        N
        LAB_DATA:
        V_ADMINBY:
        OTH
        OTHER_MEDS:
        CUR_ILL:
        Ataxia (Ataxia); Dementia (Dementia); Struma nodosa (Struma nodos)
        HISTORY:
        Medical History/Concurrent Conditions: TIA (Status post TIA)
        PRIOR_VAX:
        SPLTTYPE:
        ATPFIZER INC2021089054
        FORM_VERS:
        2
        TODAYS_DATE:
        03 February 2021
        BIRTH_DEFECT:
        OFC_VISIT:
        ER_ED_VISIT:
        ALLERGIES:
        V_FUNDBY:
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